It could pose problems for some local patients with unusual ailments related to their nervous system.

PinnacleHealth Neurology Associates will close Dec. 31. The practice is at Pinnacle’s Fredricksen Outpatient Center in Hampden Twp.

Neurologists deal with disorders of the nervous system. Their patients include people affected by conditions such as stroke, seizure disorders, diseases including multiple sclerosis and headaches stemming from hard-to-identify causes.

Pinnacle said the decision was prompted by a general shortage of neurologists and the recent departure of two neurologists.

“The decision to close was not an easy one. Neurology is an education-intensive specialty that few physicians choose to pursue,” Pinnacle said in a letter to patients.

He also said Dr. Barbara O’Connell, a neurologist, will continue seeing patients with movement disorders at a Pinnacle office in Silver Spring Twp.

Kellis said Pinnacle believes other neurological practices in the area can meet the needs of patients formerly served at the Pinnacle practice.

Still, there’s a national shortage of neurologists that’s affecting the Harrisburg region.

Dr. Stephen Ross, a neurologist at Penn State Milton S. Hershey Medical Center and president of the Pennsylvania Neurological Society, said there’s a sufficient local supply to serve patients such as stroke patients.

But patients with unusual, complicated conditions involving symptoms such as headaches, numbness and shaking might have trouble finding the appropriate neurologist, he said.

“There’s a relative shortage of these specialists. So whenever one of these facilities closes, it will have an impact on people’s ability to get care in a timely fashion,” Ross said.

Pinnacle’s Kellis said the neurologists who staffed the Fredricksen-based practice are the same ones who care for Pinnacle’s hospitalized patients.

Given the difficulty in recruiting neurologists, the demands of caring for both hospitalized patients and office patients became too much, he said.

Pinnacle’s neurosurgeons are a separate group and aren’t affected by the practice closing, Kellis said.

The shortage of neurologists is the result of forces that also have created shortages of other specialists, including rheumatologists, who deal with joints; pulmonologists, who deal with the lungs; and endocrinologists, are play an important role in treating diabetics, Ross said.

In each of those specialties, much of the work involves figuring out complicated problems rather than performing medical procedures. Yet it’s procedures that provide most of the revenue and income for medical practices and doctors.

Toby Mazer, a nurse who directs a stroke and neuroscience program at Thomas Jefferson University in Philadelphia, said the shortage of neurologists is directly related to there being few procedures for office-based neurologists.

Most of their work involves examinations that result in referrals for tests and hospital procedures. Beyond that, they might only see the patient twice a year, she said.

In addition, neurology requires four years of training after medical school — a period in which income is relatively small. Because of the high debt medical students often incur, they gravitate toward specialties in which they can do more procedures and generate more revenue and income, she said.

“Neurology has almost no procedures ... if a procedure needs to be done, it’s being done by the neurosurgeons,” Mazer said. “Outpatient neurology is just not a profitable thing.”

Hershey Medical Center’s Ross said Penn State College of Medicine has turned out roughly 650 doctors over the past five years, with only 11 choosing neurology.

The supply of neurologists is concentrated in big cities. Another problem is that most neurologists are over 55, he said.

Ross said that nationally, there are 4.9 neurologists per 100,000 people. The extremes range from 11 neurologists per 100,000 people in Washington, D.C., to less than two per 100,000 in Wyoming.

The Harrisburg region has 2.66 neurologists per 100,000, people, he said.

Ross said Hershey Medical draws neurology patients from as far as State College, Altoona, Bethlehem and northern Maryland.

As part of an effort to offset the shortage, it holds twice-monthly walk-in clinics that offer a streamlined process for people who need urgent neurology care. The most recent clinic drew 18 people, including some who traveled more than three hours, he said.

The standard exam takes 40 minutes to an hour, and it took two neurologists most of the day to see the patients.

The next clinic is scheduled for Dec. 15 at 30 Hope Drive on the Hershey Medical Center campus in Derry Twp.

However, Ross said the medical center makes special efforts to accommodate patients who urgently need a neurologist. He said anyone in urgent need should call Hershey Medical Center’s neurology department at 717-531-3828 or 800-243-1455.

He also said people should call the department number before coming to the walk-in clinic and to obtain information about the clinic.

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